Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet's disease

Luca Cantarini, Giuseppe Lopalco, Francesco Caso, Luisa Costa, Florenzo Iannone, Giovanni Lapadula, Maria Grazia Anelli, Rossella Franceschini, Cristina Menicacci, Mauro Galeazzi, Carlo Selmi, Donato Rigante

Research output: Contribution to journalArticlepeer-review

Abstract

Behçet's disease (BD) is a multi-systemic disorder of unknown etiology characterized by relapsing oral-genital ulcers, uveitis, and involvement of the articular, gastrointestinal, neurologic, and vascular systems. Although the primum movens of this condition remains unknown, a tangled plot combining autoimmune and autoinflammatory pathways has been hypothesized to explain its start and recurrence. In-depth analysis of BD pathogenetic mechanisms, involving dysfunction of multiple proinflammatory molecules, has opened new modalities of treatment: different agents targeting interleukin-1 have been studied in recent years to manage the most difficult and multi-resistant cases of BD. Growing experience with anakinra, canakinumab and gevokizumab is discussed in this review, highlighting the relative efficacy of each drug upon the protean BD clinical manifestations. Safety and tolerability of interleukin-1 antagonists in different doses have been confirmed by numerous observational studies on both large and small cohorts of patients with BD. In particular, the potential for Mycobacterium tuberculosis reactivation and tuberculosis development appears to be significantly lower with interleukin-1 blockers compared to tumor necrosis factor-α inhibitors, thus increasing the beneficial profile of this approach.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalAutoimmunity Reviews
Volume14
Issue number1
DOIs
Publication statusPublished - 2015

Keywords

  • Anakinra
  • Behçet's disease
  • Canakinumab
  • Gevokizumab
  • Interleukin-1
  • Tuberculosis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Medicine(all)

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